16 results
Approach to Joint Pain - Diagnostic Framework

1) Chronicity
2) Inflammatory vs Non-Inflammatory
3) Number of Joints Involved

1) Chronicity:
Pain - Diagnostic ... spondyloarthropathies, lupus ... #rheumatology # ... approach #workup ... #differential #
Myositis and Myopathies
Polymyositis 
 • Progressive, symmetric muscle weakness 
 • Elevated CK, +Anti-Jo, +Anti-Mi2
Dermatomyositis
Anti-retrovirals, Gemcitabine Lupus ... uncommon 5-15% of lupus ... Myopathies #myopathy #differential ... #diagnosis #comparison ... #rheumatology
Skin Conditions Associated with Joint Pain

Rash
	• Human parvovirus B19 infection

Malar rash
	• SLE
	• Human parvovirus B19 infection
	•
Associated with Joint ... B19 infection Malar ... lesions • Discoid lupus ... #skin #rashes #differential ... #diagnosis #rheumatology
Systemic Lupus Erythematosus (SLE) - Diagnosis and Management Summary
 • Epidemiology: 10-180/100,000, Typically Age 20-40, F:M
(SLE) - Diagnosis ... Manifestations: Malar ... • Immunologic Workup ... Erythematosus #Diagnosis ... Management #Summary #rheumatology
Systemic Lupus Erythematosus - Diagnosis
Manifestations:
 - Arthritis 69%
 - Malar rash 40%
 - Fever 36%
 -
Arthritis 69% - Malar ... (aPL) 30-45% Differential ... Diagnosis and Lupus ... symptoms #mimickers #differential ... #rheumatology
Drug Induced Lupus vs SLE
Drug Induced Lupus (DIL):
 • Epidemiology: -10% of all lupus cases, drug-dependent,
& NPSLE rare, Malar ... • Immunologic Workup ... Manifestations: Malar ... comparison #table #rheumatology ... #diagnosis #management
Hemolytic Anemia - Differential Diagnosis Algorithm
 • Sickle cells - Consider sickle cell disease (diverse genotypes):
Hemolytic Anemia - Differential ... Diagnosis Algorithm ... suspected, consider malaria ... #Diagnosis #Algorithm ... #workup #hematology
Top 10 situations when to think about lupus
1) Inflammatory joint pain (especially in the wrists and
) Inflammatory joint ... the face (many differential ... diagnoses, including ... #diagnosis #sle ... erythematosus #rheumatology
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes
Intravascular Hemolysis:
 • Mechanical Trauma (Microangiopathic hemolytic anemia):
Diagnostic Framework ... usually IgG) (e.g. lupus ... • Infections: Malaria ... Extravascular #Causes #differential ... #diagnosis #hematology
Approach to Joint Pain

History:
Is the pain from:
	• Joint
	• Adjacent bursa
	• Tendon
	• Ligament
	• Bone
	• Muscle
	• Referred from
Approach to Joint ... #Pain #MSK #rheumatology ... #approach #workup ... #differential # ... diagnosis #arthritis